To analyze trends in leaving without being seen (LWBS) rates in California emergency departments from 2015 to 2024 and assess the implications for patient care, particularly in light of the COVID-19 pandemic.
Key Findings:
LWBS rates improved from 2.8% to 2.2% before the COVID-19 pandemic, spiked to 3.4% in 2022, and decreased to 2.6% by 2024, highlighting the pandemic's impact.
Substantial variation in LWBS rates among hospitals, with urban, government-owned, and safety net hospitals showing higher rates, raising concerns about equitable access to care.
LWBS is a complex measure that does not differentiate between patients who self-triage and those who leave needing care, indicating a need for more nuanced metrics.
Interpretation:
While LWBS rates provide insight into emergency department performance, they do not adequately reflect whether patients receive necessary care, as they can be influenced by patient self-triage and hospital practices, necessitating a broader evaluation of patient outcomes.
Limitations:
LWBS does not capture the nuances of patient decisions to leave, such as feeling better or giving up due to wait times, and may be influenced by external factors like the COVID-19 pandemic.
Data limitations in hospital-reported datasets hinder the ability to assess whether patients received appropriate care, emphasizing the need for improved data collection.
Conclusion:
The study highlights the need for a more nuanced understanding of LWBS and emphasizes the importance of addressing systemic issues in emergency care to ensure all patients receive timely and appropriate treatment, particularly in the wake of the pandemic.
